SPECIAL REPORT

It's Not Tough, It's Tender Love:Problem Teens Need Compassion that

the "Tough-Love" Approach toChild-Rearing Doesn't Offer Them

MARTHA HEINEMAN PIEPERWILLIAM J. PIEPER

Editor's Note: This article originally appeared in theApril 7, 199], issue o/Chicago Medicine and is reprinted

with permission from the Chicago Medical Society. It isreprinted in CHILD WELFARE to bring it to the

attention of our readers, who would otherwise have littleopportunity to take note of it.

Parents and physicians alike are shocked, confused, and troubled by highrates of suicide, drug abuse, and truancy among teenagers.

An increasingly popular prescription for reforming out-of-control adoles-cents is the stringent approach known as "tough-love." Professionals whoadvocate tough love tell parents whose adolescents take drugs, skip school,steal, and talk back to present the teen with strict, unconditional rules foracceptable behavior. If the teen does not adhere to these demands, parentsare to mete out stem responses that range from withholding privileges toactually changing the locks to bar the difficult teen from the house.

Martha Heineman Pieper. Ph.D., is Adjunct Professor of Research, Smith CollegeSchool of Social Work. William J. Pieper, M.D., is Clinical Associate Professor ofPsychiatry, Rush Presbyterian-St. Lukes Medical School.

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The precept behind the tough-love approach is that true parental love entailsan uncompromising refusal to be manipulated by one's children; it is betterto lose an adolescent than to collude in unreconstructed teens' misbehaviorby allowing them to continue to enjoy the security and comfort of home.

However, in light of the principles of the new, comprehensive psychologycalled intrapsychic humanism developed by the authors, the tough-love ap-proach is seen to be thoroughly wrong-headed, based on a faulty notion ofhuman nature, and, in practice, to have caused grievous suffering for bothteens and their parents.

Further, tough love remains unsupported by research findings, while in-trapsychic humanism draws from the most up-to-date research on humandevelopment.

Tough Love Is Desperation

Tough love was a desperate remedy spawned by the wave of anti-Dr. Spockfeelings that initially swept the country in reaction to the unruly, drug-takingstudents who so visibly populated the 1960s. The argument went that if out-of-control adolescents were raised in conditions of Spockean permissiveness,then stern and firm limits would produce their oppositeswell-behaved, well-ordered teens who would stay out of trouble and not trouble their parents.

The ideology of tough love rests on a pessimistic view of human natureand encompasses both precepts for paradigmatic parenting and child devel-opment, as well as precepts for the process of rehabilitation needed whenchild development has gone awry.

Tough love advocates assume that, by their nature, both normal and ab-normal children are continuously driven to manipulate their parents to gratifyforbidden desires, and that parents must be ever vigilant in order to deflectand defeat this manipulation. This vigilance is expressed in the parents'ongoing skepticism about the quality of the child's motives, including thosemotives that appear to be positive and benign.

Sadly, a child will never genuinely experience tough-love parents as stablypositive, accepting, and nurturing; rather the child will experience the parents'constant, though often unstated, disapproval and skepticism.

Negative View of Human Nature

The view of human nature that undergirds the notion of tough love entailssuch a negative view of a child's natural inclinations that parents become

Martha Heineman Pieper / William J. Pieper 371

persuaded that they must be prepared to sacrifice their child to save the childfrom himself.

This willingness to sacrifice the child in the service of reclaiming him isseen as the highest and most selfless type of parental love. The premiseunderlying the nonnegotiable demand that tbe teen reform his behavior is thatthe parent who permits the delinquent teen to enjoy the privileges of homeis enabling the teen's actions. When the parents cease their enabling behaviorand force the teen to choose between anti-social behavior or the family, thesalvageable teen will ultimately choose the family.

Even if the teen does not reform in response to the parents' ultimatum andbecomes lost to the family, the tough-love advocate believes the parentsnonetheless have behaved appropriately and the loss of their child only il-lustrates that the parents had been "in denial" of the imperviousness of theteen's problems and their own powerlessness to affect them.

An illustration of the extreme harshness of tough love is the mother of amarijuana smoking teen who reported that by following the principles of toughlove she was able to feel acceptance of the intractable nature of his difficultiesand to remind herself that she was powerless to stop her children from dopingor smoking cigarettes or making bad grades.

She told her son, "I 'm going to give you a choice, and I'm doing it becauseI love you. Either be drug free or get out of the house."

In appraising this ultimatum, she concluded, "We had no guarantee thatKevin would ever want to get straight again. We had to be willing to let bimkill himself witb dope if he wanted to do that."

Tough Love Doesn't Work

The drawback to the tough love approach is tbat it does not work. Externallyimposed behavioral sanctions are no better at changing teens than they are atregulating the behavior of citizens of repressive governments. At best, sanc-tions produce a fragile truce in the form of shallow cooperation or a smol-dering, dissembling compliance, and, at worst, they result in open rebellionand defiance.

In contrast, intrapsychic humanism demonstrates that meaningful changeoccurs only when it is actively chosen by the individual as representing themost desirable type of pleasure. In the authors' view of human nature, themost desirable type of pleasure is associated with genuine self-caretakingideals and not with the pleasure of short-term pain relief. Parental facilitationof the child's pursuit of self-caretaking pleasure does not lead to licentiousnessor to the syndrome of the spoiled child.

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Dr. Spock's predilection for being nice to children was neither misguidednor harmful. The problem is that nice parenting can signify either the ac-tualization of genuine caregiving ideals or the same type of manipulation assanctions represent. Nonfacilitative parental kindness works like a bribe: itis an instrumental act that has the aim of inducing the child to behave ap-propriately for the sake of the parent, rather than an act whose sole aim is tofacilitate the child's autonomous capacity to pursue self-caretaking ideals.

Nonfacilitative Kindness

An example of nonfacilitative parental kindness is the father who spent hoursevery night helping his son with math, but who felt betrayed and becameirate when the boy decided to major in English in college instead of followinghis father into engineering. The father's manifestly supportive behavior wasactually regulated by his personal motives to have his son follow in hisfootsteps rather than by caregiving ideals to aid the boy in realizing hispotential and to choose the career that he felt would best suit him.

When parental kindness is primarily in the service of maintaining the par-ent's personal comfort, the child will have conflicts about decision making,and will be prevented from developing an autonomous, stable sense of purposeand identity.

In healthy development, the child acquires a fundamental and unshakableinner esteem based on a sense of effective purpose that is forged in the pleasurethat both parent and child fmd in the caregiving relationship. For example,when the parent delights in responding to the child's needs, tbe child feelsboth the enjoyment of having his needs met and also the greater pleasure ofhaving the capacity to cause his own inner well-being. With this foundation,the child will meet the world without any motive for self-induced pain, andwithout any vulnerability to disturbances in self-esteem caused by losses thatresult from chance or entropy.

When parents, in spite of their best intentions, cannot provide the childwith the stable caregiving that engenders the unshakable inner esteem of self-regulated purpose, the child, unfortunately, cannot accurately assess the causeof the displeasure she or he experiences.

On the contrary, in the absence of the mother goose, imprinting to a humancaregiver takes place in goslings, despite the human's inability to provide thegoslings with stable, ideal care. So, too, the child will accept unstable nurture,believe in it as ideal, and appetitively seek it. In other words, in psycho-pathology the child develops motives for what an observer can recognize as

Martha Heineman Pieper I William J. Pieper 373

the psychic pain of self-defeating behavior, but which the child unconsciouslyexperiences as motives for pleasure. These learned motives for illusional typesof inner well-being coexist with and regulate the remnants of innately deter-mined motives for genuine inner pleasure.

Conflict Causes Swings

The conflict between these two opposing sets of motives characterizes allpsychopathology. Wben the child's unhealthy motives for unpleasurable ex-periences (which the child accords the illusional meaning of pleasure) aregratified, the healthy self of the child, which seeks genuine pleasure, expe-riences a loss that it attempts to rectify.

Similarly, when the child achieves even a moment of success, the feltsatisfaction represents a loss to the self of the child that pursues "unpleasure"under the illusion that it represents well-being. As is illustrated by the fol-lowing case example, the ongoing competition between motives for incom-patible types of pleasure accounts for much of the lability exhibited by thetroubled teen.

Fifteen-year-old Adam had short spurts of positive behavior in which hewould attend school, do his homework, and remain sober. Soon, however,he would begin to cut classes, stay out all night, and come home drunk orhigh the next morning. Adam's parents and family doctor concluded fromthese cyclical behaviors that the boy "can be good when he wants to."

The school counselor, a tough-love advocate, told the parents they wereenabling the boy's delinquency and instructed them to tell Adam that hisdelinquent behavior would no longer be tolerated. Accordingly, they informedhim that his slides into self-destructiveness would be met with increasinglystringent restrictions of privileges.

Adam made a heroic effort to remain positively focused, but eventually heskipped-school and stayed out all night, at which point he was told that hecould not go out on weekends. He soon began sneaking out of the house onSaturday nights, whereupon the school counselor advised the parents to followthe principles of tough love and to lock him out. The boy defiantly respondedthat he was glad to leave and went to live with a friend.

After a spurt of attending classes, Adam began drinking heavily, takingdrugs, and skipping school altogether until he was on the verge of expulsion.Fortunately, at this point the parents, frightened at seeing their son deteriorateso precipitously, consulted their family physician, who advised them to engagea psychiatrist.

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In getting Adam to the psychiatrist, the parents had to ignore the strenuousobjections of the school counselor, who insisted the boy should not be pre-vented from "bottoming out," and also that psychodynamic psychotherapywas worthless in treating substance abuse and truancy problems.

The psychiatrist's training in intrapsychic humanism allowed her to un-derstand the boy's swings from positive to negative behaviors as manifesta-tions of the conflict that characterizes all psychopathology between innatelybased motives for pleasure derived from self-caring behaviors, and learnedmotives for an inner well-being gained from self-defeating behaviors.

She helped Adam understand that when things went well, the self thatpursued inner well-being through the gratification of pain-seeking motiveswas like an alcoholic deprived of drink, and that he was driven at all coststo gratify these motives. Only when these motives had been satiated, wouldthe self that pursued genuine inner well-being become functional once again.The psychiatrist explained to Adam's parents that periods of negative behaviorwere actually triggered by periods of positive behavior and that, althoughthese self-destructive behaviors were motivated, they were not freely chosen.

Tough Love Dumped

She explained the "tough-love" approach only gratified and buttressed thepain-seeking part of Adam's personality. The psychiatrist enabled the parentsto understand that during the periods when their son's behavior was out ofcontrol, he needed their understanding and supportnot confrontation andultimatums. For example, she advised them to help Adam get out of bed andto drive him to school on mornings when school avoidance seemed to beimminent.

The psychiatrist also helped the parents realize that even at the times whenAdam was functioning well, he needed their ongoing, steady help to shoreup his positive motives. For example, she advised the father to leave workto attend a performance of the boy's small rock group, which was the oneextracurricular activity Adam pursued whole-heartedly. In implementing thepsychiatrist's advice, the parents experienced the double satisfaction of seeingtheir son on the path to health and of following parenting ideals that gavethem pleasure rather than pain.

The parents also sustained their increasing sense of competence by keepingin mind the psychiatrist's caution that even if the parents were unswervinglyunderstanding and supportive, they would still witness swings in the boy'sbehavior. The psychiatrist emphasized that these lapses were part of the

Martha Heineman Pieper / William J. Pieper 375

healing process and that, over time, they would abate. In fact, this predictionwas bome out.

Results Seen

After a few months, Adam's negative motives began to be expressed lessdestructively. Adam might be 20 minutes late to school after a week of beingon time, or might be a day late handing in an assignment in a class in whichhe was doing well. Adam's self-caretaking motives became sufficiently dom-inant, and he was able to graduate from high school and continue on tocollege.

By the time of his high-school graduation, Adam's motives to establish afeeling of inner well-being through the pursuit of destructive pleasure wererarely gratified directly, and were often relegated to dreams. For example,after a stretch of doing very well in his English class, Adam dreamt he forgotto do an assignment, came drunk to the fmal exam, and failed it. He sharedthe dream with his psychiatrist with the comment that he guessed his motivesto mess up were so frustrated they had to come out somewhere.

Given the popularity of the approach to children captured in the adage,"Spare the rod and spoil the child," it is important to emphasize that thetender love we suggest as a replacement for the ideology of tough love is notan act of irresponsible indulgence made in the service of denying the realityof a teen's self-destructive behavior.

Rather, tender love entails an approach to the delinquent teen that helpsparents acknowledge the severity of their adolescent's problem while simul-taneously maintaining an unshakable commitment to help the teen resolve it.

Fundamental Differences

Tender love and tough love each endorse the basic precept that parents mustunequivocally avoid encouraging the teen's delinquent behavior. Tough loveapplies this tenet to mean that any parental involvement with the unreformedteen represents collusive and, therefore, enabling behavior, and that parentsshould react suspiciously to their own tender feelings toward and wishes forcloseness with their child. In contrast, intrapsychic humanism distinguishesbetween the teen and the delinquent behavior perpetrated by the teen.

Intrapsychic humanism asserts that the adolescent's motives for self-de-structive behavior are neither the teen's only operative motives, nor even themotives the adolescent intrinsically finds most appealing. Therefore, intra-

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psychic humanism does not accept the tough love tenet that the only route tonondeiinquent behavior is through the teen's latent capacity to comply withthe parental directives. No matter how thoroughgoing the teen's motives fordelinquent behavior appear to be, they coexist with motives to pursue hu-manistic ideals, which can be strengthened by caregetting intimacy with theparents (and, if clinically indicated, with a professional).

From the standpoint of intrapsychic humanism, withholding active parentalinvolvement strengthens the teen's most pathological motive, whereas offeringthe teen an unconditional caregiving commitment is a powerful aid to the selfof the adolescent that seeks inner well-being through genuinely self-caretakingtypes of pleasure.

Therapeutic parenting of the troubled adolescent includes such concreteefforts as being available for discussions, driving the teen to and from school,assisting with homework, establishing curfews with the adolescent and helpingthe teen to adhere to them, and, if indicated, providing psychiatric help. Theknowledge that the turning away from self-destructive behaviors is an unevenprocess makes it possible for parents to respond to the adolescent's inevitablelapses with renewed commitment rather than with self-criticism and the painfulconclusion that their supportive efforts enable the teen's misbehavior. Theadolescent, in turn, will have the important and growth-promoting experiencethat even though the parents are aware of the strength of the teen's motivesfor an inner well-being derived from a self-destructive type of pleasure, theyare prepared to go to any lengths to aid the self of the adolescent that has amotive to pursue a genuine type of self-caretaking pleasure.

Parents Give Up Pleasure

One of the most tragic consequences of tough love is that parents are advisedto relinquish the deepest pleasure available to themthe pleasure of caringfor their child. Although some parents may react to the precepts of tenderlove with occasional reservations that they may be spoiling the child, we havefound that when they respond constructively to the child's self-destructivemotives, parents take great satisfaction in their newfound caregiving capacity.They often voice great relief and gratitude that they have regained positivefeelings for their child, feelings for which parents universally yearn. Parentsnearly always say they found the precepts of tough love a heart-wrenchingexperience, which, in spite of continued attempts to convince themselves theywere acting in the best interests of their child, caused them considerable innerdisquiet.

Martha Heineman Pieper I William J. Pieper '^11

Using the principles of intrapsychic humanism, the physician consulted bythe family can offer both parents and adolescent an articulated viewpointbased on constructive principles that promote an active, nurturing engagementrather than a destructive rending of the family. By adopting a view of humannature as congenitally disposed to seek positive, relationship-oriented pleasurerather than as innately driven toward antisocial acts that must be thwartedand suppressed, both professional and parent can pursue an optimistic, fa-cilitative, and realistic approach to the adolescent.

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